Instant Text in the Press

WINDOWS TECHNOLOGY
Adds Visual Skills to the MT's Ear

by Robert T. Hill

ADVANCE for Health Information Professionals - September 9, 1996
Special to Advance

LAST MONTH saw the first
anniversary of the release of
Windows 95, the much
ballyhooed operating system
that is running increasingly more
of the world's computers.
Although Windows 95 is only one
year old, Windows as a product
line and the graphical user
interface (GUI) as a concept are
certainly not new ideas, GUIs have
been in development for decades,
and Windows was a latecomer in
1985 with the release of Windows
1.0.

By 1993 or so, most of the
computing world had switched to
the Windows GUI or one of its
competitors — most of the
computing world, but not medical
transcriptionists (MTs). To date,
the majority of MTs have resisted
the pressures to switch to
Windows, becoming one of the last
bastions of DOS-based word
processors and abbreviation
software. However, as the medical
records industry pursues the
electronic patient record,
Windows-based OLE-compliant
software is required.

AS A result, medical
transcriptions are starting to use
Windows word processors and
other Windows " productivity
software," replacing the DOS
systems of yesterday. Windows
may not be new, but it is
encountering new users in the
medical transcription field.

Certainly, there are advantages
and disadvantages to consider
when choosing DOS or Windows
professional transcription tools.
Indeed, the are never-ending
discussions about this taking place
in Internet forums and office
lunchrooms. While Windows
systems do require faster processors and
more memory, these are getting
cheaper by the day. While DOS
word processors may offer bare-bones
efficiency for lightning-fast
keying, Windows documents can
be embedded in other Windows
applications, a vital feature as
computers move to a uniform
interface for all applications
and X-ray images on the
same computer screen.

To date, the majority of MTs have
resisted the pressures to switch to
Windows, becoming the last bastions
of DOS-based word processors and
abbreviation software.

While some people still
enjoy the option of deciding
which system to use, others
are realizing they must move
to Windows. Whatever the
reason behind the move,
there are certain
advantageous features in
Windows that DOS does not
have. Perhaps the greatest of
these is the potential relief
from the memorization and recall
paradigm in favor of the visual
recognition paradigm that is
inherent in GUIs.

BY ITS very nature, Windows
presents information visually,
which is then recognized, as
opposed to being recalled from
memory. Many user actions are
directed by visual cues. Rather
than remember the sequence for
opening a file, for instance, the
user sees the File/Open pull-down
menu and follows the clue. Or,
rather than type out the name of
an .EXE file one merely clicks on
the icon for it.

This principle is also found in
Windows transcription programs.
And what is it that is presented for
visual recognition? The words,
phrases and terms of art are the
stock and trade of medical
language, our specialized
vocabulary.

Consider the medical
dictionary. Pick up a dictionary
and turn randomly to any page
that is mostly word entries (as
opposed to images, charts, etc.).
Scan the entries and see how
many of them you can recognize
or at least deduce an accurate
meaning. Most people find they
can recognize perhaps 70 percent
of the words on a given page. If
you assume a conservative figure
of 400,000 words in a medical
dictionary and compute 70 percent
recognition, you have a potential
vocabulary of about 280,000
words. Yet, our working
vocabularies are perhaps 10,000
or 15,000 words, a fraction of the
potential.

THE KEY is not to know every
possible word but instead be able
to use reference materials as
necessary to invoke the words we
need when we need them. We
already use paper dictionaries and
glossaries for this purpose. When
transcribing, we may hear a word
that we can't remember how to
spell, perhaps "capsulorrhaphy."
Traditionally, we have turned to
glossary reference manuals to help
jog the memory. On seeing the
word in print we can deduce the
information we need and go on. It
is by such recognition skills that
we wield extremely large
vocabularies. It is often not
necessary to define the word, only
see it.

By guessing a few letters like "cprr"
the transcriptionist is presented
with a display of all words
in Instant Text's current glossary
that match the input clue.

Windows abbreviation
expansion programs like Instant
Text (Textware Solutions,
Burlington, MA) can use electronic
glossaries to replace the paper
ones. Up to 256,000 words and
phrases can be on tap, ready to be
displayed based on the guess of a
few letters. Once displayed, the
appropriate word or phrase can be
selected. It's that simple. The
model of using a reference manual
no longer need be limited to flipping paper pages.
Most words and phrases needed for
the transcription task can be made
available as visual cues in
electronic, and therefore faster,
format.

TAKE THE example of
"capsulorraphy" in Instant Text
(see Figure). By guessing a few
letters like "cprr," the
transcriptionist is presented with a
display of all words in the current
glossary that match the input clue
"cprr." This word can then be
selected for inclusion in the text
being generated. It is not necessary
to open a book or even remove the
hands from the keyboard to find a
visual memory aid and arrive at
the correct spelling of the word.

Transcriptionists can use
Windows technology to expand
their working vocabulary by
allowing them instant access to the
thousands of words and phrases
that they can recognize but
perhaps do not remember. This is
particularly useful for highly
specialized vocabularies like
medical language, where one often
comes across arcane names like
Rothmund-Thomson syndrome or
complicated drug names like
pHiso-Hex. With Windows,
transcriptionists can use entire
dictionaries as their working
vocabularies, and both words and
phrases can be made available for
quick recognition and use.

Transcription still requires "the
ear," but with Windows,
transcriptionists can add "the eye."
Windows programs excel at
presenting information visually. For
transcriptionists, this means that
the words and phrases found in
our reference materials can now
be found before our eyes as well as
at our fingertips.

THERE IS a vast difference
between the number of words in
our working vocabularies (those
that we remember) and the
number of words in our potential
vocabularies (those that we can
recall). The visual recognition
paradigm that is inherent in
Windows transcription software
exploits this difference and
dramatically increases the number
of word and phrases that the
transcriptionist can use. The
bottom line for the medical
transcription industry is that this
may help to reduce the time it
takes to turn a novice
transcriptionist into an experienced
veteran.

About the author: Robert T.Hill is a self-taught medical
transcriptionist from New York who
beta tested Instant Text. He is also a
free-lance writer and a Fossil Explainer with
the American Museum of Natural
History in New York.